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We are finally beginning to understand migraines and how to treat them

After 40 years of research, scientists have uncovered what happens in the brain during a migraine and developed promising new drugs to tackle the condition. Here’s what we now know – and what still remains unanswered

By Jessica Hamzelou

26 January 2022

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Jasu Hu

I WAS 15 years old and halfway through a family meal when the blow to my head came out of nowhere. It felt as if someone had clobbered me on the side of the skull with a mallet, the sudden pain making me drop my fork. Then came a second hit. And a third. I remember pleading with my sister to stop her noisy whingeing before running to hide under a duvet until the pain eventually subsided. I had experienced my first migraine.

Twenty years later, my migraine-coping technique remains largely unchanged, except that it is now my toddler whose whining becomes unbearable. Migraine treatments don’t really work for me. They don’t really work for a lot of people.

Despite migraine being among the most common neurological conditions, affecting around a billion people worldwide, we know incredibly little about what causes them, how to avoid them and how best to treat them.

That is partly because migraines are so complex. They impact people differently, can be unpredictable and affect many more women than men. Migraine research has been dismissed, derided and underfunded. But a handful of dedicated scientists have spent decades trying to make progress. For the first time, they have uncovered a mechanism behind migraines in the brain, and with this knowledge have developed treatments not only to relieve them when they strike, but possibly to stop them occurring. Finally, migraine science is having its moment.

For those lucky enough to be unfamiliar with migraines, they can seem far-fetched. Someone can be fine one minute, then suddenly unable to speak or see. The symptoms are varied, and can last …

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